CommercialCoverageMedium impact
Lab Testing for Alzheimer’s Disease 2.02.16
Excellus BlueCross BlueShield·Neurology, Geriatrics, Family Medicine +1 more·Genetic Disease (Inherited Disease)
Effective date
Oct 15, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield has established new coverage criteria for Alzheimer's disease lab testing, effective October 15, 2025. The policy covers genetic testing for PSEN/APP genes in specific family history scenarios, APOE testing for FDA-approved amyloid therapies, and CSF biomarker testing for treatment initiation, while classifying many other biomarker tests as investigational.
Action Required
Before October 15, 2025: Billing team must review all Alzheimer's disease lab test orders to ensure they meet the new coverage criteria. Update prior authorization processes to verify patients meet specific requirements for genetic testing (family history documentation), APOE testing (mild cognitive impairment/dementia diagnosis), and CSF biomarker testing (treatment initiation criteria). Flag investigational tests that will likely be denied including TREM2, MindX Memory, PrecivityAD2, and plasma panel tests.